Provider First Line Business Practice Location Address:
JBSA-RANDOLPH CLINIC 559 MEDICAL SQUADRON
Provider Second Line Business Practice Location Address:
221 3RD ST W
Provider Business Practice Location Address City Name:
RANDOLPH AFB
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78150
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-652-4264
Provider Business Practice Location Address Fax Number:
210-652-4264
Provider Enumeration Date:
03/08/2006